An update to the Antenatal and Postnatal Mental Health Guideline has been issued and is catching up with the caesarean guideline in recognising that a fear of childbirth can be a major challenge to some women. The guideline now recommends that:
“For a woman with tokophobia (an extreme fear of childbirth), offer an opportunity to discuss her fears with a healthcare professional with expertise in providing perinatal mental health support in line with section 1.2.9 of the guideline on caesarean section (NICE guideline CG132).”
In a step towards joined up thinking this, in theory, means that women should be able to discuss their fears of childbirth, increasing their likelihood of getting the support they need.
However automatically steering them away from a request caesarean in favour of vaginal birth should not be the focus of this support. Rather it should aim to help women develop the confidence to make informed decisions for themselves. Hopefully practitioner interpretation of the guidelines will recognise this. Of course specifying the term ‘tokophobia’ may give some the get out they want in order to turn away requests from women without the diagnosis. However knowing about these two guidelines and what they really mean, prior to antenatal appointments, give women a new advantage.